Ohio Infant Mortality Reduction Initiative (OIMRI)

Overview

Although infant deaths have declined over the years, infant mortality rates for African-American babies is almost three times the rate for whites, 16.7 and 6.1 per 1,000 live births respectively in 2006. Important determinants of racial/ethnic differences in infant mortality are low birth weight (LBW) and very low birth weight (VLBW). Black women in Ohio are more likely than white women to deliver a LBW infant (7.6 percent and 14.2 percent respectively in 2006). Eliminating racial disparities in infant mortality will require a focus on reducing LBW and VLBW through the implementation of strategies aimed at improving the quality of prenatal care, pre-conception and inter-conception health; identifying underlying medical conditions; and understanding the role social supports and how environmental factors such as stress and race contribute to poor birth outcomes.  While Ohio has a safety net system of health care for uninsured/underinsured and Medicaid consumers, significant barriers to pregnant women and children accessing those services remain. The Ohio Infant Mortality Reduction Initiative (OIMRI) component of the Child and Family Health Services program at the Ohio Department of Health addresses the barriers (e.g., financial, geographic, cultural, infrastructural.) African-American women and children experience and improves their access to and utilization of health care.

The OIMRI programs are funded to provide community-based outreach and care coordination services in targeted communities with high-risk, low-income African-American pregnant women and families. When a disparate health condition affects the general population, it affects low-income and people of color at a higher rate and more severely.

The OIMRI component utilizes the community care coordination model to empower communities to eliminate disparities. The community care coordination model supports employing individuals from the community as trained advocates who empower pregnant women to access resources. These professional community health workers (CHW’s) provide a cultural link to the community and to community resources through family-centered services.  These services focus on achieving success in health, education and self-sufficiency. The CHW conducts case finding; makes home visits on a regular basis during pregnancy and through the baby’s second year of life; identifies and reinforces risk reduction behaviors; provides appropriate education; identifies and works with the client’s strengths; methodically engages the client in incorporating life-changing behaviors; and collaborates with other agencies in making appropriate referrals to assure positive pregnancy and infant health outcomes. 

The OIMRI community care coordination model includes five core components: 1) planning; 2) training; 3) supervision; 4) standardized care processes; and 5) data collection and evaluation. Planning includes using current data to target OIMRI services in specific neighborhoods and census tracts with the highest rates of poor birth outcomes and associated risk factors. Planning also may include conducting client surveys of prenatal care appointment waiting times; consumer surveys to determine specific barriers to care;  Geographic Information System (GIS) mapping of infant mortality, low birth weight and other risk factors; and assessment of the availability of prenatal care providers in the targeted community.  Standardizing the education and training of community care coordinators and supervisors is an important component of the model.  The care coordination model uses a standardized care process that facilitates consistency of home visiting procedures and clearly delineates the expected actions of the community care coordinator. Establishing and implementing a common data collection system that documents the impact of services is vital to measuring success. 

OIMRI programs exist in 13 counties in Ohio with high infant mortality rates.  They are Allen, Butler, Clark, Cuyahoga, Franklin, Hamilton, Lorain, Lucas, Mahoning, Montgomery, Richland, Stark and Summit counties.  

Mailing Address:
Ohio Department of Health
Bureau of Child and Family Health Services
246 North High Street
Columbus, OH  43215

Telephone: (614) 466-5332
Fax: (614) 564-2443

Last Updated:   8/26/08
Last Reviewed: 8/01/08